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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제55권 제4호
발행연도
2014.1
수록면
1,087 - 1,094 (8page)

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Purpose: This study was designed to evaluate the mid-term results and efficacy of subtalar distraction double bone-block arthrodesis for calcaneal malunion. Materialsand Methods: From January 2004 to June 2007, we operated on 6 patients (10 cases). There were 5 males (9 cases) and 1 female (1 case), four of which presentedwith bilateral calcaneal malunion. Seven cases were operated on initially. The period between initial injury and arthrodesis was 23 months, and the average followup period was 58 months. In operation, we applied an extensile lateral approachand arthrodesis was performed through a tricortical double bone-block and cannulated screws. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT were examined to assess union and various parameters. Results: The mean age of the patients was 41 years. All cases achieved radiologic union at the final follow-up. The mean AOFAS Ankle-Hindfoot scale (maximum of 94 points) increased from 43.3 points preoperatively to 85.4 points at the final follow-up. The radiologic analysis of the pre- and postoperative standing lateral radiographsshowed improvements of 5.6 mm in talo-calcaneal height, 1.8° in talocalcanealangle, 5.1° in talar declination angle and 5.3° in talo-first metatarsal angle. Conclusion: Subtalar distraction two bone-block arthrodesis provides overall good results not only in the short term but also the mid-term with significant improvementin clinical and radiologic outcomes. This procedure warrants considerationfor managing calcaneal malunion with loss of height and subtalar arthritis.

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